Meningococcal disease: The advances and challenges of meningococcal disease prevention

Abstract

Vaccination as a means to prevent meningococcal disease caused by Neisseria meningitidis is critical given the abrupt onset and rapid progression of this disease. Five serogroups--A, B, C, W-135, and Y--are responsible for the majority of cases. In developed countries, infants have the greatest risk of disease, with a smaller secondary peak observed in late adolescence. Vaccines utilizing the polysaccharide capsule are poorly immunogenic in young children but can reduce the incidence of meningococcal carriage in high risk groups. In contrast, protein conjugate vaccines to polysaccharide capsules A, C, W-135, and Y have broadened the population protection from disease but their effect on meningococcal carriage and transmission is yet unknown except for monovalent meningococcal C conjugate that has been shown to reduce carriage. Challenges remain in providing direct protection to infants and protection against meningococcal B disease. To date, outer membrane vesicle vaccines have been used to control meningococcal B disease in epidemic settings and vaccine candidates against subcapsular antigens are in development, but a vaccine that confers long-lasting protection is unavailable.

Molecular Characterization of Invasive Neisseria meningitidis Strains Isolated in Chile during 2010–2011

“…Three quadrivalent polysaccharide conjugate vaccines that use different protein carriers and cover serogroups A, C, W135 and Y are currently available and have been proved to be an effective measure to control IMD caused by these serogroups [22]. However, with the exception of strain-specific vaccines developed as a response to long-standing outbreaks in Cuba, Norway and New Zealand, no effective vaccine is available against serogroup B disease.…”

“…There are currently several vaccines, some of them in very advanced stages of development, that target different OMPs. These vaccines have been designed using those OMP variants that are more commonly found among hyperinvasive meningococci and have shown promising results against all meningococcal strains, including serogroup B [22]. As these vaccines are being developed on the basis of genetic data, the implementation of molecular characterization into routine laboratory surveillance is of paramount importance for decision-making bodies for an evidence-based decision on the implementation of preventive measures against the disease.…”

Prevalence and Phase Variable Expression Status of Two Autotransporters, NalP and MspA, in Carriage and Disease Isolates of Neisseria meningitidis

“…In rare cases, hyper-virulent meningococci invade the epithelial layers and enter the bloodstream resulting in rapidly fatal septicemia and meningitis [1]. The use of conjugate polysaccharide vaccines targeting some disease-associated serogroups has helped limit the impact of disease in several countries; however, a prerequisite for comprehensive prevention in the developed world will be an effective and widely used vaccine against serogroup B meningococci (MenB) [3]. One vaccine developed for this purpose is 4CMenB (Bexsero).…”

Neisseria meningitidisinfection: who, when and where?

“…They contained OMV present on a specific bacterium surface [160] and this limits their use only in case of local outbreaks. Moreover, they induce a short-term protection [160][161][162]. A hypothetical effective vaccine against 78% of serogroup B cases in Europe is 4CMenB (commercial name Bexsero Ò , GSK Vaccines).…”